MEDICARE: SPINAL HEALTH CARE ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	111NR0400X	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3725535	OTHER	TN	MEDICARE PTAN NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	08123318	OTHER	TN	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1316137243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPINAL HEALTH CARE ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	8132 CORDOVA RD
Second Line	:	SUITE 102
City	:	CORDOVA
State	:	TN
Zip	:	38016-6005
Country	:	US
Telephone Number	:	901-751-0939
Fax Number	:	901-751-0332

Provider Business Practice Location Address
First Line	:	8132 CORDOVA RD
Second Line	:	SUITE 102
City	:	CORDOVA
State	:	TN
Zip	:	38016-6005
Country	:	US
Telephone Number	:	901-751-0939
Fax Number	:	901-751-0332

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROCK WOOSTER
Credential	:	DC
Telephone Number	:	901-751-0939

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	08/26/2013

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Directions to “SPINAL HEALTH CARE ASSOCIATES, P.C. ” Practice Location

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